Mechanisms of Labor

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Included In This Lesson

Study Tools For Mechanisms of Labor

Stages of Labor (Cheatsheet)
Stages of Childbirth-Head (Image)
Engagement of Fetus (Image)
Stages of Childbirth (Image)
Mechanism of Labor (Picmonic)
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Outline

Overview

  1. Cardinal movements-specific movements the baby does, in this specific order, to exit mom successfully
    1. This all happens fluidly during the process of delivery
  2. Fetus has to be well engaged and mom in true labor to be successful
  3. Membranes must rupture or be ruptured

Nursing Points

General

  1. Occasionally referred to as the Cardinal Movements
    1. Engagement
    2. Descent and flexion
    3. Internal rotation
    4. Extension
    5. Restitution and external rotation
    6. Expulsion
  2. True labor vs. false labor
    1. The uterus is a muscle and it contracts to prepare for childbirth
      1. False labor-can feel like true labor
      2. It is important to be able to differentiate between true vs. false labor.

Assessment

  1. Cardinal Movements explained
    1. Engagement:  where the presenting part descends through the pelvic inlet
      1. May be called lightening or dropping
      2. Occurs approximately 2 weeks before delivery
    2. Descent and flexion: process of presenting part (typically the head) going through mom’s pelvis, occur simultaneously as a fluid movement
      1. Baby flexes head down
      2. Descent is measured by station, continuous process until delivery
      3. 0 station = presenting part at ischial spine
      4. Minus station is up
      5. Plus station is closer to delivery
    3. Internal rotation: baby rotates within the birth canal
      1. Baby’s face in line with mom’s rectum
    4. Extension: baby’s head extends
      1. Begins after crowning
      2. Complete when chin is out of perineum
    5. Restitution and external rotation: occur simultaneously as a fluid movement
      1. Baby re-aligning its head with body
    6. Expulsion: baby’s entire body is out
  2. True labor vs. false labor
    1. True labor is progressive, regular, and becomes stronger
    2. If mom changes activity (going from resting to walking) and the contractions stop, it is FALSE labor
    3. True labor produces dilation, effacement, engagement and descent
      1. False labor does not do any of the above
    4. Other events that occur just before labor occurs
      1. Lightening
      2. Vaginal discharge increases
      3. Brown/blood tinged cervical mucus passes
      4. Cervix gets ready by ripening, potentially dilating/effacing
      5. Burst of energy can occur 24-48 hrs before (“nesting”)
      6. Estrogen and progesterone levels fluctuate, causing a fluid shift and subsequent weight loss of 2.2-6.6 kg approximately 24-48 hrs prior to labor
      7. Rupture of Membranes
  3. Rupture of membranes
    1. PPROM: Preterm premature rupture of membranes
      1. Greatest risk to baby occurs when this occurs before 37 weeks
      2. High risk for infection
        1. Bacteria gets in because prolonged rupture
    2. PROM: premature rupture of membranes
      1. Rupture prior to labor
      2. Can be gush of fluid or steady leak
    3. ROM: spontaneous rupture of membranes at full term
      1. AROM: artificial rupture of membranesDone with a tool or hand of physician

Therapeutic Management

  1. Rupture of membrane
    1. Might need to perform AROM
    2. Described as “water breaking”
    3. Absence of the buffer of the amniotic fluid in uterus. Fetal head will be on cervix and will stimulate uterine contractions and therefore labor
    4. Can be anywhere from 50-300 ml
  2. May need to perform Nitrazine test to determine if mother has urinated or ruptured membranes
    1. Tests pH of fluid
    2. Amniotic fluid has a pH of 7-7.5 and will turn test strip blue
      1. Alkaline

Nursing Concepts

  1. Reproduction
  2. Comfort

Patient Education

  1. True vs. False labor
    1. True: contractions can be timed regular, get stronger and closer together, do not stop with rest or activity
    2. False: Contractions are not regular, do not get stronger or closer together, stop with rest, hydration, and activity
  2. When to call MD
    1. Rupture of membranes
    2. Contractions 5 minutes apart
    3. bleeding

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Transcript

In this lesson I will explain how labor and the delivery occurs and your role in assisting the patient in a successful delivery.

The mechanisms of labor are known as the cardinal movements. These are the movements that the fetus does to find its way out. So first the fetus has to be engaged. This is the head in the pelvis engaged in and not moving back up. This can happen a few weeks before delivery and is also known as “lightening”. Now descent, so the fetus is moving further towards the “exit” and flexion of the head occurs. Flexion is that chin to chest to help the fetus move it’s way out. Descent is spoken in terms of the station that the fetus is in. This is discussed in the module on process of labor but basically you can see in this image that zero station means the fetus is at the ischial spines of the pelvis. As the baby gets closer to delivery it will be lower which is measured in centimeters and described as +1, +2 and so on. If the fetus is higher up above the ischial spines then it is -1,-2 and so on. The fetus will then have internal rotation. So it is going to rotate itself around then extend itself.

So after internal rotation we have extension. It will extend its neck so it is not chin to chest anymore to better get itself under those pelvis bones. The face is aligned with the maternal rectum and extends its head. This movement ends with the head delivering. Then there will be external rotation. So the head is delivered and it will rotate to realign its body. Sometimes the physician will help to do this. Last is expulsion. That fetus is going to expel the rest of its body out. In this image you can see the head is applied to the cervix and the cardinal movements start. The head is engaged and there is descent of the fetus. The fetus internal rotates and extends. External rotation can now occur to deliver or expel the rest of the body. There is also a great youtube video attached to this lesson that you can watch to visualize each movement.

For mechanisms of labor the patient needs to be in true labor. So let’s look at true labor versus false labor. True labor are contractions that are regular and can be timed. They are contractions that cause cervical change so dilation and effacement. Nothing stops them. False labor occurs because the uterus is a muscle and it contracts to prepare for childbirth. So it has to get the body ready. Sometimes false labor can feel like true labor. False labor are contractions that are not strong or regular. They make no cervical change. False labor can be stopped by hydrating and resting. Patients will also be told to walk to see if contractions are true labor. Walking will either cause them to get stronger and closer together because they are true labor but in false labor they will stop or not increase.

Now let’s look at the other items that occur prior to labor. Lightening is when the fetus drops, this just means the fetus descends further into the pelvis. When this happens two things occur. The patient can breath better because the fetus is lower and off the lungs. So that is a plus! But now it is lower and puts pressure on the bladder so the patient will have to void more. Vaginal discharge increases because of the cervix ripening and getting softer. There might be brown or blood tinged cervical mucus passing. This is pieces of the mucus plug. If you are a labor nurse then you will no doubt will have a patient at some point show up with a tupperware container and her mucus plug in it! They think this thing comes out and it means it is baby time. It can occur a few weeks prior to delivery though. Some woman won’t lose the plug as a whole. Some women will just have increased discharge and this is still the plug thinning out. The cervix is going to be softening and ripening possibly making some slight dilation and effacement. The patient might have a burst of energy known as nesting where the patient is quickly cleaning everything and getting ready for the baby. A fluctuation in hormones can cause a fluid shift and so weight loss might occur.

For delivery the bag of water must break. This can occur in several ways and different times. A PPROM means preterm premature rupture of membranes. This occurs prior to 37 weeks and the patient is at risk for infection. PROM is premature rupture of membranes. This occurs prior to labor. So she ruptures but is not in contracting. This could be a gush of fluid or a steady leak. Patients can either SROM, which is a spontaneous rupture of membranes at full term or AROM, which is an artificial rupture of membranes. This is done by the physician with an instrument to break the water. Infection is a risk for any rupture because that barrier is gone. PPROM patients are at the greatest risk because they are not in labor, which means they will be pregnant longer with no barrier.

Our management might involve rupturing the membranes or bag of water. This would be when the physician performs an AROM. When this occurs it gets rid of the buffer of the amniotic fluid in uterus. Fetal head will be able to drop and be on cervix and will stimulate uterine contractions and then labor. For a patient that comes in thinking that her water has broken then we may need to perform a Nitrazine test. This will determine if mother has urinated or ruptured membranes. Pregnant patients pee on themselves, it just happens so it is not an uncommon thing to have occur. The test is a strip of paper that is vagincally swabbed and it will turn blue if it is the amniotic fluid. The fluid is alkaline so it will turn blue in the presence of amniotic fluid.
The patient is going to need to be educated on true versus. false labor. In true labor the contractions can be timed regular, get stronger and closer together. and they do not stop with rest or activity. False labor is when contractions are not regular, do not get stronger or closer together, they stop with rest, hydration, and activity. They need to also know when to call the physician. SO for things like rupture of membranes, contractions 5 minutes apart, and bleeding.

Reproduction is reproduction has occurred and comfort to be provided during labor.
Ok so let’s look at our key points. The cardinal movements are engagement, descent and flexion, internal rotation, extension, restitution and external rotation, and expulsion. Labor can be true or false so we need to ask are they regular contractions? Is there cervical change? Do they go away or stay? And last our rupture of membranes. If it happens prior to 37 weeks it’s PPROM. PROM is rupture prior to labor. SROM is when the patient ruptures on her own at term and AROM is when the physician does it. It is artificial rupture.

Make sure you check out the resources attached to this lesson and look at each movement for the cardinal movements. Now, go out and be your best selves today. And, as always, happy nursing.

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Monalisa’s Study Plan

Concepts Covered:

  • Community Health Overview
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  • Communication
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  • Central Nervous System Disorders – Spinal Cord
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Study Plan Lessons

Community Health Course Introduction
EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Fundamentals Course Introduction
OB Course Introduction
12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Electrical A&P of the Heart
Glaucoma
Intro to Community Health
Menstrual Cycle
Overview of Developmental Theories
What Guides Nurses Practice
54 Common Medication Prefixes and Suffixes
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
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Cataracts
Community Health Nursing Theories
Electrolytes Involved in Cardiac (Heart) Conduction
Family Planning & Contraception
Fluid Pressures
Kohlberg’s Theory of Moral Development
Vitals (VS) and Assessment
Community Health Education
Nursing Care and Pathophysiology for Cushings Syndrome
Fluid Shifts (Ascites) (Pleural Effusion)
Macular Degeneration
Nursing Care Delivery Models
Piaget’s Theory of Cognitive Development
Pressure Ulcers/Pressure injuries (Braden scale)
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Essential NCLEX Meds by Class
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Growth & Development – Infants
Health Promotion Model
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Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
6 Rights of Medication Administration
Environmental and Genetic Influences on Growth & Development
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Health Promotion Assessments
Hearing Loss
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Family Structure and Impact on Development
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Body Image Changes Throughout Development
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Premature Atrial Contraction (PAC)
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Abortion in Nursing: Spontaneous, Induced, and Missed
Growth & Development – Early Adulthood
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Benzodiazepines
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Growth & Development – Middle Adulthood
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Cardiac (Heart) Disease in Pregnancy
Nursing Care and Pathophysiology for Endometriosis
Growth & Development – Late Adulthood
Nephroblastoma
Prioritization
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Critical Thinking
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The Nurse Routine
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Process of Labor
Process of Labor
Vomiting
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Mechanisms of Labor
Mechanisms of Labor
Therapeutic Communication
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Leopold Maneuvers
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Fetal Heart Monitoring (FHM)
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Postpartum Physiological Maternal Changes
Kohlberg’s Theory of Moral Development
Postpartum Interventions
Bronchiolitis and Respiratory Syncytial Virus (RSV)
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Erikson’s Theory of Psychosocial Development
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Family Structure and Impact on Development
SSRIs
Body Image Changes Throughout Development
Cystic Fibrosis (CF)
Cultural Awareness and Influences on Development
Developmental Considerations for the Hospitalized Individual
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Newborn of HIV+ Mother
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
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Magnesium Sulfate
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Meds for PPH (postpartum hemorrhage)
Rh Immune Globulin (Rhogam)
Lung Surfactant
Eye Prophylaxis for Newborn (Erythromycin)
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Parasympathomimetics (Cholinergics) Nursing Considerations
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Epoetin Alfa
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Magnesium Sulfate
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ABG (Arterial Blood Gas) Interpretation-The Basics
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ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Absolute Neutrophil Count (ANC) Lab Values
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Addiction – Behavioral Problems Nursing Mnemonic (The 5 D’s)
Addisons Assessment Nursing Mnemonic (STEROID)
ADLs (Activity of Daily Living) Nursing Mnemonic (BATTED)
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Airborne Precaution Diseases Nursing Mnemonic (MTV)
Alanine Aminotransferase (ALT) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Albumin Lab Values
Alcoholism – Outcomes Nursing Mnemonic (BAD)
Alkaline Phosphatase (ALK PHOS) Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alkalosis and Acidosis Nursing Mnemonic (Kick Up, Drop Down)
Alpha-fetoprotein (AFP) Lab Values
Alpha-fetoprotein (AFP) Lab Values
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Alzheimer – Diagnosis Nursing Mnemonic (The 5 A’s)
Ammonia (NH3) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Anion Gap
Anion Gap Acidosis 1 Nursing Mnemonic (KULT)
Anion Gap Acidosis 2 Nursing Mnemonic (MUDPILES)
Anorexia – Signs and Symptoms Nursing Mnemonic (ANOREXIA)
Antepartum Testing
Anticholinergics – Side Effects Nursing Mnemonic (4 Can’ts)
Antinuclear Antibody Lab Values
Antinuclear Antibody Lab Values
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Aortic Stenosis Symptoms Nursing Mnemonic (SAD)
Appendicitis – Assessment Nursing Mnemonic (PAINS)
ARDS causes Nursing Mnemonic (GUT PASS)
Arterial Blood Gases Nursing Mnemonic (ROME)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Assessment of a Burn Nursing Mnemonic (SCALD)
Assessment of Guillain-Barre Syndrome Nursing Mnemonic (GBS=PAID)
Asthma management Nursing Mnemonic (ASTHMA)
At Risk for Gout Nursing Mnemonic (MALE)
AVPU Mnemonic (The AVPU Scale)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Base Excess & Deficit
Benzodiazepines Nursing Mnemonic (Donuts and TLC)
Beta 1 and Beta 2 Nursing Mnemonic (1 Heart, 2 Lungs)
Beta Hydroxy (BHB) Lab Values
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Bicarbonate (HCO3) Lab Values
Bleeding Complications (Minor) Nursing Mnemonic (BEEP)
Bleeding Precautions Nursing Mnemonic (RANDI)
Blood Type O Nursing Mnemonic (Universally Odd)
Blood Urea Nitrogen (BUN) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
BPH Symptoms Nursing Mnemonic (FUN WISE)
Brain Natriuretic Peptide (BNP) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
Bulimia – Signs and Symptoms 1 Nursing Mnemonic (BULIMIA)
Bulimia – Signs and Symptoms 2 Nursing Mnemonic (WASHED)
C-Reactive Protein (CRP) Lab Values
C-Reactive Protein (CRP) Lab Values
Cancer – Early Warning Signs Nursing Mnemonic (CAUTION UP)
Cancer – Nursing Priorities Nursing Mnemonic (CANCER)
Canes Nursing Mnemonic (COAL)
Carbon Dioxide (Co2) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cardiac (Heart) Enzymes
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Caring Licensed Practical Nurse Nursing Mnemonic (CLPN)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)
Causes of Pancreatitis Nursing Mnemonic (BAD HITS)
Causes of Poor Gas Exchange Nursing Mnemonic (All People Can Value Lungs)
Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)
Causes of Renal Calculi Nursing Mnemonic (Patients Complain of Pain and Difficulty Urinating)
Chest Tube Assessment Nursing Mnemonic (Two AA’s)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Child Abuse/Neglect – Warning Signs Nursing Mnemonic (CHILD ABUSE)
CHO, CHO, CHON Nursing Mnemonic (CHO, CHO, CHON)
Cholesterol (Chol) Lab Values
Cholesterol (Chol) Lab Values
Cholinergic Crisis – Signs and Symptoms Nursing Mnemonic (SLUDGE)
Chorioamnionitis
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Cirrhosis Complications Nursing Mnemonic (Please Bring Happy Energy)
Cleft Lip Repair – Post Op Care Nursing Mnemonic (CLEFT LIP)
Coagulation Studies (PT, PTT, INR)
Coagulation Studies (PT, PTT, INR)
Common Pathogens for UTI Nursing Mnemonic (KEEPS)
Common Signs of Parkinson’s Nursing Mnemonic (SMART)
Community Health Tool Nursing Mnemonic (MAP-IT)
Complications of Spinal Cord Injuries Nursing Mnemonic (ABCDEFG)
Complications of Thoracentesis Nursing Mnemonic (Patients Sometimes Bleed Internally)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
COPD management Nursing Mnemonic (COPD)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cortisol Lab Vales
Cortisol Lab Vales
Cranial Nerve Mnemonic 01 Nursing Mnemonic (Olympic Opium Occupies Troubled Triathletes After Finishing Vegas Gambling Vacations Still High)
Cranial Nerve Mnemonic 02 Nursing Mnemonic (Oh Oh Oh To Touch And Feel Very Good Velvet AH!)
Cranial Nerve Mnemonic 03 Nursing Mnemonic (On Old Obando Tower Top A Filipino Army Guards Villages And Huts)
Creatine Phosphokinase (CPK) Lab Values
Creatine Phosphokinase (CPK) Lab Values
Creatinine (Cr) Lab Values
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Creatinine Clearance Lab Values
Crohn’s Morphology and Symptoms Nursing Mnemonic (CHRISTMAS)
Cultures
Cultures
Cushings Assessment Nursing Mnemonic (STRESSED)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Cyclic Citrullinated Peptide (CCP) Lab Values
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
D-Dimer (DDI) Lab Values
Decrease ICP Nursing Mnemonic (Craniums Excite Me)
Dementia Nursing Mnemonic (DEMENTIA)
Depression Assessment Nursing Mnemonic (SIGNS)
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
Diarrhea – Treatment Nursing Mnemonic (BRAT)
Direct Bilirubin (Conjugated) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Disseminated Intravascular Coagulation (DIC)
Dissociative Disorders
Diverticulitis Complications Nursing Mnemonic (Please Fix His Abscess SOon)
DKA Treatment Nursing Mnemonic (KING UFC)
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Drugs that Cause SJS Nursing Mnemonic (I C NASA)
Dysrhythmias Labs
Dysrhythmias Labs
Ectopic Pregnancy
Eczema
Electrolytes – Location in Body Nursing Mnemonic (PISO)
Emergency Drugs Nursing Mnemonic (LEAN)
Environmental Health Assessment Nursing Mnemonic (I PREPARE)
Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)
Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)
Erythrocyte Sedimentation Rate (ESR) Lab Values
Erythrocyte Sedimentation Rate (ESR) Lab Values
Evaluation of Irregular Moles Nursing Mnemonic (ABCDE)
Exercise Guidelines Nursing Mnemonic (FIT)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Family Planning & Contraception
Fetal Alcohol Syndrome (FAS)
Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)
Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)
Fibrin Degradation Products (FDP) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fibrinogen Lab Values
Fire Safety 1 Nursing Mnemonic (PASS)
Fire Safety 2 Nursing Mnemonic (RACE)
Flu Symptoms Nursing Mnemonic (FACTS)
Fluid Compartments
Free T4 (Thyroxine) Lab Values
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
GERD causes Nursing Mnemonic (Reflux Is Probably Mean)
Gestational Diabetes (GDM)
Global Symptoms for Brain Tumors Nursing Mnemonic (HAS)
Glomerular Filtration Rate (GFR)
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucagon Lab Values
Glucose Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Glucose Tolerance Test (GTT) Lab Values
Gluten Free Diet Nursing Mnemonic (BROW)
Gravidity and Parity (G&Ps, GTPAL)
Growth Hormone (GH) Lab Values
Growth Hormone (GH) Lab Values
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)
Hematocrit (Hct) Lab Values
Hematocrit (Hct) Lab Values
Hemodynamics
Hemoglobin (Hbg) Lab Values
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hemoglobin A1c (HbA1C)
Hemorrhagic Stroke Risk Factors Nursing Mnemonic (HATS)
Hepatitis B Virus (HBV) Lab Values
Hepatitis B Virus (HBV) Lab Values
Hiatal Hernia Symptoms Nursing Mnemonic (Her Belly Really Hurts Following Dinner)
High Pressure Vent Alarms Nursing Mnemonic (Kings Eat Big Cakes)
High Risk Behavior Nursing Mnemonic (HEADSS)
Homocysteine (HCY) Lab Values
Homocysteine (HCY) Lab Values
Human Growth & Development Course Introduction
Hyperbilirubinemia (Jaundice)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperemesis Gravidarum
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperkalemia – Signs and Symptoms Nursing Mnemonic (Murder)
Hypernatremia – Causes Nursing Mnemonic (MODEL)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Hypoxia – Signs and Symptoms Nursing Mnemonic (RAT BED)
IADLS (Instrumental Activities of Daily Living) Nursing Mnemonic (SCUM)
Incompetent Cervix
Increase MAP Nursing Mnemonic (VAK)
Inflammation- Signs and Symptoms Nursing Mnemonic (HIPER)
Insulin Mnemonic (Ready, Set, Inject, Love)
Interventions for Aphasia Nursing Mnemonic (PROP)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Ionized Calcium Lab Values
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Panels
Lab Values Course Introduction
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Leukemia – Signs and Symptoms Nursing Mnemonic (ANT)
Levels of consciousness Nursing Mnemonic (Never Carry Dirty Socks Or Smelly Clothes)
Levels of Prevention
Lidocaine Toxicity – Signs and Symptoms Nursing Mnemonic (SAMS)
Lipase Lab Values
Lipase Lab Values
Lithium Lab Values
Lithium Lab Values
Liver Function Tests
Liver Function Tests
Low Pressure Vent Alarms Nursing Mnemonic (Cake Everyday)
Lymphoma – Signs and Symptoms Nursing Mnemonic (NURSE For Pete’s Sake)
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Management of Lyme Disease Nursing Mnemonic (BAR)
Management of Pressure Ulcers (Pressure Injuries) Nursing Mnemonic (SKIN)
Manic Attack – Signs and Symptoms Nursing Mnemonic (DIG FAST)
MAO Inhibitors Nursing Mnemonic (TIPS)
Maslow’s Hierarchy of Needs in Nursing
Mastitis
Maternal Risk Factors
Mean Corpuscular Volume (MCV) Lab Values
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Meconium Aspiration
Medication Classess for IBD Nursing Mnemonic (Sometimes I Can’t Answer)
Medications for Pancreatitis Nursing Mnemonic (Please Make Tummy Better)
Medications to Prevent Seizures Nursing Mnemonic (Pretty Little Liars Forever)
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Menstrual Cycle
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Methemoglobin (MHGB) Lab Values
Mnemonic for Organ Systems (MR DICE RUNS)
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Myocardial Infarction Nursing Mnemonic (MONATAS)
Myoglobin (MB) Lab Values
Myoglobin (MB) Lab Values
OB Non-Stress Test Results Nursing Mnemonic (NNN)
OLD CARTS Mnemonic (OLD CARTS)
Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)
Order of Lab Draws
Order of Lab Draws
Pain Assessment Questions Nursing Mnemonic (OPQRST)
Pediatric Bronchiolitis Labs
Pediatric Bronchiolitis Labs
Pharmacokinetics Nursing Mnemonic (ADME)
Phosphorus (PO4) Blood Test Lab Values
Phosphorus (PO4) Blood Test Lab Values
Planning Community Health Interventions Nursing Mnemonic (PRECEDE-PROCEED)
Platelets (PLT) Lab Values
Platelets (PLT) Lab Values
Pneumonia Labs
Pneumonia Labs
Pneumonia Risk Factors Nursing Mnemonic (VENTS)
Pneumothorax Signs and Symptoms Nursing Mnemonic (P-THORAX)
Possible Infections During Pregnancy Nursing Mnemonic (TORCH)
Post-Partum Assessment Nursing Mnemonic (BUBBLE)
Postpartum Hemorrhage (PPH)
Potassium-K (Hyperkalemia, Hypokalemia)
Prealbumin (PAB) Lab Values
Prealbumin (PAB) Lab Values
Pregnancy Labs
Pregnancy Labs
Pregnancy Outcomes Nursing Mnemonic (GTPAL)
Premature Rupture of the Membranes (PROM)
Preterm Labor
Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)
Procalcitonin (PCT) Lab Values
Procalcitonin (PCT) Lab Values
Process of Labor – Mom Nursing Mnemonic (4 P’s)
Process of Labor – Baby Nursing Mnemonic (ALPPPS)
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Prostate Nursing Mnemonic (FUN)
Prostate Specific Antigen (PSA) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Protein (PROT) Lab Values
Protein (PROT) Lab Values
Protein in Urine Lab Values
Protein in Urine Lab Values
Proton Pump Inhibitors
Pulmonary edema treatment Nursing Mnemonic (MAD DOG)
Pupil Reactions Nursing Mnemonic (PERRLA)
Reactivation of Herpes Zoster Nursing Mnemonic (FICA)
Reasons for a Bronchoscopy Nursing Mnemonic (Please Assess His Weird Bronchoscopy Results)
Reasons for Chest Tube Nursing Mnemonic (Don’t Ever Fail)
Red Blood Cell (RBC) Lab Values
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Renal (Kidney) Failure Labs
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Restrictive Lung Disease Causes Nursing Mnemonic (PAINT)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Risk Factors for Cholelithiasis Nursing Mnemonic (5-F’s)
Risk Factors for Osteoporosis Nursing Mnemonic (ACCESS)
ROME – ABG (Arterial Blood Gas) Interpretation
Safety Check Nursing Mnemonic (MADLE)
SBAR Communication Nursing Mnemonic (SBAR)
Schizophrenia
Scleroderma Symptoms Nursing Mnemonic (CREST)
Seizure Causes Nursing Mnemonic (VITAMIN)
Seizure Documentation Nursing Mnemonic (TDOC)
Senile Dementia – Assess for Changes Nursing Mnemonic (JAMCO)
Sepsis Labs
Sepsis Labs
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shorthand Lab Values
Shorthand Lab Values
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Signs of Pregnancy (Presumptive, Probable, Positive)
Sprains and Strains – Nursing Care Nursing Mnemonic (RICE)
SSRI’s Nursing Mnemonic (Effective For Sadness, Panic, and Compulsions)
Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)
Stages of Hepatitis Nursing Mnemonic (PIP)
Steps in the Nursing Process 1 Nursing Mnemonic (ADPIE)
Steps in the Nursing Process 2 Nursing Mnemonic (AAPIE)
Steps In The Nursing Process 3 Nursing Mnemonic (SOAPIE)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoke Assessments Nursing Mnemonic (FAST)
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Symptoms of Wernicke’s Encephalopathy Nursing Mnemonic (COAT)
TB Drugs Nursing Mnemonic (RIPE)
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Toxicity Sepsis- Signs and Symptoms Nursing Mnemonic (The 6 T’s)
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Traction – Nursing Care Nursing Mnemonic (TRACTION)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Trauma – Assessment (Emergency) Nursing Mnemonic (ABCDEFGHI)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Triage Nursing Mnemonic (START)
Triiodothyronine (T3) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
Troponin I (cTNL) Lab Values
Two pathways of the peripheral nervous system Nursing Mnemonic (SAME)
Types of Anemia Nursing Mnemonic (Always Introduce Special Patients)
Types of Hemorrhoids Nursing Mnemonic (Pie)
Ulcerative Colitis – Assessment Nursing Mnemonic (MADE 10)
Umbilical Cord Vasculature Nursing Mnemonic (2A1V)
Urinalysis (UA)
Urinalysis (UA)
Urinary Elimination
Urine Culture and Sensitivity Lab Values
Urine Culture and Sensitivity Lab Values
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Vasospasm Therapy Nursing Mnemonic (Triple H Therapy)
VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)
Vitamin B12 Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
Vitamin D Lab Values
Vitamins – Fat Soluble Nursing Mnemonic (All Dogs Eat Kibble)
Vitamins – Water Soluble Nursing Mnemonic (Birth Control)
Walkers Nursing Mnemonic (Wandering Wilma Always Late)
White Blood Cell (WBC) Lab Values
White Blood Cell (WBC) Lab Values
Who Needs Dialysis Nursing Mnemonic (AEIOU)